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Wrist Arthroscopy PDF Evidence

Illustration of keyhole (arthroscopic) wrist surgery: a small camera and instruments enter the wrist through tiny portals on the back of the joint to inspect and treat the triangular fibrocartilage complex (TFCC) and other structures.
Wrist arthroscopy is keyhole surgery: a camera and fine instruments work through a few small portals on the back of the wrist. What your recovery looks like depends on what was done inside. Kieran Hirpara 4.0

A recovery plan after keyhole (arthroscopic) wrist surgery, where the pace depends on what was done inside: a clean-up (debridement, synovectomy, ganglion or central TFCC tidy-up) allows early movement and a quick return, while a TFCC repair protects forearm rotation in a splint or cast for about four to six weeks before motion and strength are rebuilt.

This protocol guides your recovery after keyhole (arthroscopic) surgery on the wrist with Dr Kieran Hirpara at Mater Private Hospital Rockhampton. Wrist arthroscopy is done through a few tiny incisions (portals) on the back of the wrist, so the skin heals quickly — but the pace of your recovery depends on what was done inside the joint. It begins with your home exercise program, followed by the structured clinical protocol written for your hand therapist — bring this page or its PDF to your first therapy visit so your rehabilitation stays coordinated, and so your therapist follows the plan that matches your operation. Your therapist may adjust the plan depending on how your recovery progresses.

If you have any concerns about your wounds after surgery, get in touch with the rooms. It is often helpful to take a photo of the wound and email it for review.

What to expect

Wrist arthroscopy means the surgeon works inside your wrist through small keyhole portals using a tiny camera and fine instruments. Because the cuts are small, the skin and soft tissues heal fast — but the inside of the wrist sets the timetable, and there are two very different recovery paths:

  • A clean-up (debridement, synovectomy, dorsal ganglion removal, or a central TFCC tidy-up). Here, nothing is stitched back together that needs protecting — damaged or inflamed tissue is simply trimmed or removed. So immobilisation is brief (often just a soft dressing or short splint for comfort), wrist movement begins within days, and you return to most activities over a few weeks. The central part of the TFCC (the cushion on the little-finger side of the wrist) has no blood supply and cannot heal if stitched, so when it is torn there it is trimmed rather than repaired — and that trimming behaves like a clean-up.

  • A TFCC repair (a peripheral or foveal tear stitched back down). The outer rim of the TFCC does have a blood supply and can heal, so when it is torn there it is repaired — and that repair must be protected. The single biggest stress on a healing TFCC repair is turning the forearm (rotating the palm up and down). Because of that, the wrist and forearm are rested in a splint or a Muenster (above-elbow) cast for about four to six weeks — this lets the elbow bend but blocks the forearm rotation that would pull on the repair. Movement, then strength, are then rebuilt in careful stages, and full recovery takes around three months or more.

Throughout both paths, the fingers are kept moving from the start (they were not operated on), swelling is controlled, and the small portal scars are looked after. Your hand therapist will follow the plan for what was actually done in your wrist — if you are unsure which path you are on, ask Dr Hirpara or check your operation note.

Precautions and limitations

  • Keep your fingers moving from the start — make a fist and straighten out fully, several times a day. This is always allowed and prevents stiffness and swelling.
  • Follow the plan for what was done. After a clean-up, gentle wrist movement starts within days. After a TFCC repair, the wrist and forearm stay protected in a splint or cast and you do NOT turn the forearm (palm up / palm down) until your hand therapist clears it (about four to six weeks).
  • After a TFCC repair, do NOT force or load forearm rotation, and do NOT grip or lift heavily until cleared — rotation and load are exactly what stress the repair.
  • Keep the keyhole portals clean and dry until healed; do NOT soak or scrub them. Look after the small scars once they have healed.
  • Do NOT drive while your wrist is splinted, casted, or unable to safely control the wheel; arrange help with transport in the early weeks.
  • Use the hand for light everyday tasks within comfort, as long as it does not involve the movements or loading you have been told to avoid.

For wound, swelling and scar management, see the practice's wound care guidance.

Your exercises

Making a full fist then fully straightening the fingers to keep them supple and reduce swelling.

Kieran Hirpara 4.0

Finger movement (early)

From the first day or two, slowly make a full fist, then straighten your fingers all the way out. The fingers are not part of what was repaired, so keeping them moving is encouraged from the start — it controls swelling and stops the hand stiffening. Do this even while your wrist is resting in a splint or cast.

10 times, several times a day, from the start

Gently bending the wrist up and down and side to side, within the range your hand therapist allows.

Kieran Hirpara 4.0

Wrist movement (per your plan)

If you had a clean-up (debridement, synovectomy or ganglion removal), gentle wrist bending up and down — and side to side — usually begins within a few days, as soon as comfort allows. If you had a TFCC repair, the wrist is rested in a splint or cast first, and wrist movement begins later, only when your hand therapist starts it. Always stay within the range you have been given.

10 times each direction, 2–3 times a day, once started

With the elbow tucked at the side, turning the palm up towards the ceiling then down towards the floor.

Kieran Hirpara 4.0

Forearm rotation — palm up / palm down (per your plan)

With your elbow tucked at your side, gently turn your palm up towards the ceiling, then down towards the floor. After a clean-up this can usually begin early. After a TFCC repair this is the LAST motion to be freed — turning the forearm stresses the repair, so it is held back in a splint or cast for about four to six weeks and then re-introduced gradually. Only do this once your hand therapist has cleared it.

10 times each direction, 2–3 times a day, once cleared

Scar and portal care

Once the small portal wounds are fully healed and dry, massage each little scar with a fingertip using a plain moisturiser, in small circles. Keyhole portals are tiny but can feel tight or sensitive — gentle massage and tapping (desensitisation) keep the skin supple and settle any tenderness.

A few minutes, 2–3 times a day, once wounds are healed

Squeezing a soft ball or putty to rebuild grip strength once cleared.

Kieran Hirpara 4.0

Grip strengthening (later)

A LATER exercise — only once your hand therapist starts it. Squeeze a soft ball or therapy putty, hold briefly, then relax. After a clean-up, light gripping often begins within a couple of weeks; after a TFCC repair, strengthening waits until about eight weeks, once movement has returned. Build the effort up gradually and stop if it is sharply painful.

10–15 squeezes, 2–3 times a day, when cleared

These are the exercises from your handout. Start them only as guided by Dr Hirpara and your hand therapist, staying within whatever range and limits you have been given. Finger movement and swelling control begin from the start for everyone. Wrist movement, forearm rotation and grip are gated by what was done — early after a clean-up, but held back after a TFCC repair (forearm rotation especially, which is the last thing to be freed). Scar and portal care begins once the small wounds have healed. Stop anything that causes sharp pain.

Your clinical protocol

The rest of this page is the staged clinical protocol for rehabilitation after wrist arthroscopy. This section is to be provided to the hand therapist, and each phase opens with a plain-English explanation of what is happening. The protocol forks on what was done. A diagnostic-or-therapeutic clean-up (debridement, synovectomy, dorsal ganglion excision, chondral or scapholunate debridement, central TFCC debridement) follows the early-motion path. A peripheral/foveal TFCC repair follows the protected-rotation path, because forearm rotation loads the repair. Always confirm with the operation note and the treating surgeon which path applies.

Prior to treatment, check the patient's operation report and past medical history, and liaise with the treating surgeon regarding the procedure performed (pure debridement/synovectomy/ganglion/central-TFCC debridement vs peripheral/foveal TFCC repair), any associated DRUJ instability, and the prescribed immobilisation. The two pathways below differ chiefly in how long forearm rotation is protected.

Path A — Clean-up (debridement / synovectomy / ganglion / central-TFCC debridement): early-motion

The clean-up path removes or trims tissue without creating a construct that needs protecting, so the goal is to restore motion early and avoid stiffness. Immobilisation is brief and for comfort only.

Phase I — early motion (weeks 0 to 2)

The first couple of weeks settle swelling and pain while motion begins almost immediately.

For your hand therapist:

Education and precautions - Immobilisation is soft dressing or a short splint for comfort only, typically up to ~2 weeks; no rotation restriction for a pure central debridement/synovectomy/ganglion - Fingers, thumb and (where comfortable) wrist move from day one - Keep portals clean and dry until healed

Management - Oedema: elevation, gentle finger pumping, ice as needed - Exercises: full active finger and thumb ROM from the start; active wrist flexion/extension and radial/ulnar deviation as comfort allows within the first days; gentle forearm pronation/supination as comfort allows - Wound: portal dressings as directed; monitor for infection

Criteria to progress - Portals healed; swelling settling; comfortable early ROM

Phase II — restoring motion and starting strength (weeks 2 to 6)

Motion is normalised and light strengthening is added once range is comfortable.

For your hand therapist:

Assessments - Active and passive wrist ROM and forearm rotation; grip; pain and swelling; scar/portal review

Management - Exercises: progress to full wrist and forearm ROM; begin light grip and putty strengthening from around 2 weeks; commence scar/portal desensitisation and massage once healed - Progress functional hand use as comfort allows

Criteria to progress - Near-full painless ROM; settled swelling; grip building

Phase III — strengthening and return (weeks 4 to 6 and beyond)

Strength and task tolerance are built back; most patients return to normal activity over a few weeks. Note that a clean-up gives reliable symptom relief but is not guaranteed for diffuse or recalcitrant ulnar-sided pain — manage expectations where pain is non-focal.

For your hand therapist:

Management - Exercises: graded grip and forearm/wrist strengthening; task- and work-specific loading - Return to light/most activity typically 2–6 weeks; heavier manual or sporting load as tolerated and criterion-based - Consider discharge once strength is near-symmetrical and function restored

Path B — Peripheral / foveal TFCC repair: protected rotation

The repair stitches the outer (vascularised) rim of the TFCC back down. Because forearm rotation stresses the repair, the forearm is protected in a splint or Muenster (above-elbow) cast — which allows elbow flexion/extension but blocks pronation/supination — for about four to six weeks. Motion, then strength, are then graded back.

Phase I — protected immobilisation (weeks 0 to 6)

The repair is protected from rotational load while the fingers stay mobile. Practice varies, but the most common pattern is forearm immobilisation in neutral-to-slight-supination for about six weeks; an above-elbow (Muenster) cast or splint is used when rotation must be firmly controlled.

For your hand therapist:

Education and precautions - Immobilise to protect forearm rotation: splint or Muenster/above-elbow cast (elbow free, forearm rotation blocked), forearm in neutral to slight supination, for ~4–6 weeks (commonly 6) - No active or passive forearm pronation/supination during this phase - Full finger and thumb ROM from day one; gentle shoulder ROM - Keep portals clean and dry; monitor for infection

Management - Oedema: elevation, finger pumping, ice as needed - Exercises: finger/thumb AROM; isolated elbow flexion/extension if a Muenster permits; no wrist or forearm rotation loading - Wound/scar: portal care; begin scar work once healed

Criteria to progress - ~4–6 weeks elapsed; repair protected; portals healed; fingers supple

Phase II — graded motion (weeks 6 to 8)

The cast/splint comes off and motion is rebuilt, introducing forearm rotation last and gradually, as it is the motion that stressed the repair.

For your hand therapist:

Assessments - Wrist and forearm ROM; pain and swelling; scar review

Management - Exercises: begin active wrist flexion/extension and radial/ulnar deviation; gradually re-introduce forearm pronation/supination within comfort — build the rotation arc up over the following weeks rather than forcing it - Continue scar/portal desensitisation

Criteria to progress - Comfortable, improving wrist and forearm ROM; pain settling

Phase III — strengthening and return (weeks 8 to 12+ and beyond)

Strengthening begins once roughly 70–100% of wrist and forearm motion is restored, then load and task tolerance are graded back.

For your hand therapist:

Assessments - Grip and forearm strength versus the other side; pain/swelling response to loading; functional and work-/sport-specific testing

Management - Exercises: begin grip and forearm/wrist strengthening from around 8 weeks, once 70–100% of ROM is regained; progress to graded resisted and task-specific loading - Return to sport/heavier work is criterion-based, typically around three months (range ~3–4+ months depending on demand) - Consider discharge once strength is near-symmetrical and function restored; refer back to the treating doctor if recovery plateaus or DRUJ instability recurs

Getting back to work and activity

Light everyday hand use — eating, writing, light self-care — is encouraged from the start within comfort, as long as it stays within the limits you have been given. Driving resumes once you are out of any splint or cast and can safely control the wheel, as confirmed at your review; plan for help with transport in the early weeks.

How quickly you return depends on what was done. After a clean-up (debridement, synovectomy, ganglion or central-TFCC tidy-up), most people are back to normal light activity within two to six weeks, with heavier load built back as comfort allows. After a TFCC repair, forearm rotation is protected for about four to six weeks, strengthening begins from around eight weeks, and return to sport or heavier manual work is usually around three months — judged by regaining movement and adequate, symmetrical strength, not by the calendar alone, and decided by Dr Hirpara and your hand therapist together.

After your protocol

This protocol works alongside the practice's general recovery advice — see managing post-operative pain, wound care and scar management. If your operation involved the distal radioulnar joint or you are unsure which pathway applies, the distal radioulnar joint (DRUJ) hemiresection protocol is a related sibling. The phased plan above reflects published rehabilitation guidance after wrist arthroscopy and TFCC surgery, and your ongoing recovery is guided individually by Dr Hirpara and your hand therapist according to how your wrist progresses.

Reviewed by Dr Kieran Hirpara · 2026-06-21 03:03:24.501282+00:00.

Want the clinical detail? Read the clinician version.

Talk to your treating clinician for advice specific to you.

For an appointment with the CQ Hand + Upper Limb team, ask your GP about a referral or visit www.cqupperlimb.com.

Evidence & references

Wrist Arthroscopy — Procedure Outcomes & Post-operative Rehabilitation (Diagnostic / Therapeutic Keyhole Wrist Surgery)

Topic scope: post-operative rehabilitation after arthroscopic wrist surgery through small dorsal portals — covering debridement (central TFCC, chondral, scapholunate), synovectomy, dorsal ganglion excision, and peripheral/foveal TFCC repair. The defining feature of this topic is that a single operative approach (keyhole access) covers procedures with opposite rehabilitation needs: a clean-up creates nothing to protect and follows an early-motion pathway, whereas a repair creates a construct loaded by forearm rotation and must be protected. The rehabilitation pathway is therefore gated by what was done, not by the fact that arthroscopy was used.

Defining principle of the rehab here: wrist arthroscopy is a route, not a single operation. Where tissue is only removed (debridement of an avascular central TFCC tear, synovectomy, a dorsal ganglion, a chondral or scapholunate tidy-up), nothing has been reconstructed — immobilisation is brief and for comfort, wrist motion begins within days, and return is measured in weeks. Where the vascularised peripheral or foveal TFCC is repaired, the dominant stress on the construct is forearm rotation (pronation/supination), so the forearm is protected — typically a splint or Muenster (above-elbow) cast that frees the elbow but blocks rotation — for about 4–6 weeks, after which motion and then strength are graded back over roughly three months. The single branch point a therapist must establish from the operation note is debridement-class vs repair-class, and within repair, how long rotation is to be protected. The rehabilitation evidence itself is low-level and heterogeneous — protocols rest on biology, surgeon preference and expert/therapist consensus more than on trials.

A. PROCEDURE OUTCOMES (debridement / synovectomy / ganglion vs TFCC repair)

Wrist arthroscopy is both the diagnostic gold standard and the therapeutic workhorse for intra-articular ulnar-sided wrist pathology. The principal outcome split is between clean-up procedures and repair.

  • Wrist arthroscopy is a versatile, low-morbidity platform. Through small dorsal portals it permits direct inspection and treatment of TFCC tears, chondral lesions, synovitis and ganglia, with the keyhole approach giving fast soft-tissue healing and small scars [Gupta, Bozentka, Osterman — JAAOS 2001, DOI 10.5435/00124635-200105000-00006]. Narrative/mechanistic.
  • Arthroscopic debridement of central (Palmer 1A) TFCC tears relieves symptoms in well-selected, focal cases. The central disc is avascular and cannot heal if sutured, so trimming is the rational treatment; classic and long-term series report good symptom relief and durable function in suitable patients [Osterman — Arthroscopy 1990, DOI 10.1016/0749-8063(90)90012-3; Soreide et al., 19-year follow-up — HAND 2017, DOI 10.1177/1558944717708029]. Moderate–weak (case series, long follow-up).
  • Debridement is unreliable for diffuse, non-focal ulnar-sided wrist pain. Where pain is recalcitrant and not clearly localised to a focal central tear, simple arthroscopic debridement has little useful value on the clinical course — a caution against over-attributing diffuse ulnar wrist pain to a debridable lesion [Nishizuka et al. — Bone Joint J 2013, DOI 10.1302/0301-620x.95b12.31918]. Moderate (prospective cohort).
  • Peripheral/foveal TFCC repair restores DRUJ stability and gives good outcomes when the rim is repairable. All-arthroscopic and arthroscopic-assisted repair techniques (e.g. FasT-Fix, all-inside suture) report reliable pain relief, return of grip and high return-to-activity rates in vascularised peripheral tears, especially with DRUJ instability [Yao, Dantuluri, Osterman — Arthroscopy 2007, DOI 10.1016/j.arthro.2007.02.010; Yao — Hand Clin 2011, DOI 10.1016/j.hcl.2011.05.004]. Moderate–weak (technique series).
  • Procedure choice is driven by tear location and DRUJ stability. Central tears → debridement; peripheral/foveal tears, particularly with DRUJ instability → repair. In ulnar-positive wrists, peripheral repair may be combined with or weighed against ulnar shortening osteotomy [Papapetropoulos et al. — J Hand Surg Am 2010, DOI 10.1016/j.jhsa.2010.06.015]. Moderate.
  • Arthroscopic dorsal ganglion excision gives recurrence rates comparable to (or, in some series, better than) open excision, with the keyhole advantage of faster recovery and smaller scars. Arthroscopic resection reliably removes the cyst and addresses the stalk at its capsular origin [Nishikawa et al. — J Hand Surg Br 2001, DOI 10.1054/jhsb.2001.0620; Luchetti et al. — J Hand Surg Br 2000, DOI 10.1054/jhsb.1999.0290; Konigsberg et al. — HAND 2021, DOI 10.1177/15589447211003184; Suen, Fung, Lung — ISRN Orthop 2013, DOI 10.1155/2013/940615]. Moderate–weak (retrospective comparison + series).

B. REHABILITATION / THERAPY EVIDENCE

The central rehab question is how long, and against what, to protect the wrist — and the answer is set entirely by the procedure. The evidence base for the rehabilitation (as opposed to the surgery) is low-level and markedly heterogeneous, with no level-1 protocol and wide variation in immobilisation and progression timings; recommendations are best regarded as biologically-rationalised, consensus-driven guides rather than trial-proven schedules.

  • Clean-up procedures follow an early-motion pathway. After debridement, synovectomy or ganglion excision there is no construct to protect: immobilisation is a soft dressing or short splint for comfort (≈2 weeks at most), wrist motion begins within days, and light grip strengthening is added at around 2 weeks. Return to most activity is measured in weeks (≈2–6) [How-we-treat reviews and technique series; consistent across sources]. Weak–moderate (consensus + series).
  • TFCC repair protects forearm rotation, not just the wrist. Because pronation/supination is the dominant load on a peripheral/foveal repair, the forearm is immobilised — commonly a splint or Muenster/above-elbow cast that frees the elbow but blocks rotation — for about 4–6 weeks (six is the most commonly reported figure), in neutral to slight supination [scoping review of arthroscopic peripheral TFCC repair rehabilitation, PMC12274733; Australian hand-therapist survey of foveal-repair rehabilitation, J Hand Ther 2024]. Weak–moderate (scoping review + survey of practice).
  • Forearm rotation is re-introduced last and graded. After the protected phase, wrist flexion/extension and deviation are restored first, with pronation/supination re-introduced gradually because it is the motion that stressed the repair. Strengthening typically begins once 70–100% of wrist and forearm ROM is regained (around 8 weeks) [scoping review PMC12274733]. Weak (consensus from heterogeneous protocols).
  • Rehabilitation protocols are heterogeneous and lack consensus. Across studies, complete immobilisation ranged 1–8 weeks (forearm most commonly 6), ROM commencement and strengthening start varied widely (strengthening 3–12 weeks), and authors explicitly call for level-1 evidence. The practical implication is to follow the operating surgeon's prescription for the specific repair rather than a fixed universal schedule [scoping review PMC12274733; Australian hand-therapist survey]. Weak (the evidence's own conclusion).

Recovery trajectory (expected, evidence-anchored)

Phase Window Restraint Hand use / therapy focus Strength / load Notes
Clean-up I — early motion Week 0–2 Soft dressing / short splint for comfort Fingers move day 1; early wrist flexion/extension, deviation and gentle forearm rotation within days; portal care Light functional use No construct to protect; rotation not restricted for central debridement/synovectomy/ganglion
Clean-up II–III — restore & return Week 2–6+ Restrictions lifted Full wrist/forearm ROM; scar/portal desensitisation once healed Light grip/putty from ~2 wk, graded loading thereafter Return to most activity 2–6 wk; debridement unreliable for diffuse (non-focal) ulnar pain
Repair I — protected immobilisation Week 0–6 Forearm rotation blocked (splint / Muenster cast, neutral–slight supination) Full finger/thumb ROM day 1; elbow flexion/extension if Muenster permits; no pronation/supination None to the repair ~4–6 wk (commonly 6); rotation is the dominant repair load
Repair II — graded motion Week 6–8 Rotation re-introduced gradually Active wrist flexion/extension & deviation; forearm rotation re-introduced last and built up Light, no resisted load yet Restore motion before strength
Repair III — strengthen & return Week 8–12+ Load progressed by criteria Grip/forearm strengthening once 70–100% ROM regained; task-specific loading Strengthening from ~8 wk; graded resisted load Return to sport/heavy work ~3 months (range ~3–4+); grip ~85% of opposite side, ~87% return to pre-injury activity

(Phase windows mirror the precautions and recovery structure in the patient protocol; they are typical, consensus-derived guides — not trial-derived deadlines, and the surgeon's prescription overrides them.)

C. KEY CONTROVERSIES / EVIDENCE QUALITY

  1. Debridement vs repair is decided by tear location and DRUJ stability, not access. Central (avascular) tears are trimmed; peripheral/foveal (vascularised) tears, especially with DRUJ instability, are repaired. The same keyhole approach therefore launches opposite rehab pathways — the therapist must establish which from the operation note. Strong biological rationale, moderate clinical evidence.
  2. Debridement is not a panacea for ulnar wrist pain. It relieves focal central-tear symptoms but has little value for diffuse, recalcitrant ulnar-sided pain — a key expectation-setting point [Nishizuka 2013]. Moderate.
  3. How long to protect forearm rotation after repair is unsettled. Reported immobilisation ranges 1–8 weeks (forearm most commonly 6); there is no level-1 consensus, and practice (including Australian hand-therapist practice) varies. The defensible position is to protect rotation ~4–6 weeks and follow the operating surgeon. Weak (heterogeneous).
  4. Arthroscopic vs open ganglion excision. Recurrence is broadly comparable, with arthroscopy offering faster recovery and smaller scars; the evidence is retrospective rather than randomised [Konigsberg 2021; Nishikawa 2001; Luchetti 2000]. Moderate–weak.
  5. The rehabilitation evidence base is the weak link, not the surgery. Outcome studies of the operations outnumber and outrank the rehabilitation studies; rehab timings are biologically and consensus-driven, and the literature itself calls for level-1 trials [scoping review PMC12274733]. Weak.

D. EVIDENCE STRENGTH FLAGS (summary)

  • MODERATE: versatility and low morbidity of wrist arthroscopy as a diagnostic/therapeutic platform; symptom relief from debridement of focal central TFCC tears (with long-term series); limited value of debridement for diffuse ulnar wrist pain; comparable recurrence of arthroscopic vs open dorsal ganglion excision; good outcomes of peripheral/foveal TFCC repair when the rim is repairable.
  • WEAK / CONSENSUS: the specific rehabilitation schedules — clean-up early-motion (~2-wk comfort splint, motion within days, return 2–6 wk) and repair protected-rotation (splint/Muenster ~4–6 wk, ROM then strength from ~8 wk, return ~3 months). Immobilisation duration and progression timings are heterogeneous across the literature with no level-1 consensus; figures are typical guides, and the operating surgeon's prescription governs.
  • EXPECTATION-SETTING (natural history): grip recovers to ≈85% of the opposite side and ≈87% of patients return to pre-injury activity after TFCC repair; debridement of diffuse (non-focal) ulnar wrist pain may not relieve symptoms.

CITATIONS

RAG corpus (180,000+ Orthopaedic articles)

  • Wrist arthroscopy: principles and clinical applications. J Am Acad Orthop Surg. 2001. DOI: 10.5435/00124635-200105000-00006
  • Arthroscopic debridement of triangular fibrocartilage complex tears. Arthroscopy. 1990. DOI: 10.1016/0749-8063(90)90012-3
  • Arthroscopic-assisted resection of triangular fibrocartilage complex lesions: a 19-year follow-up. HAND. 2017. DOI: 10.1177/1558944717708029
  • Simple debridement has little useful value on the clinical course of recalcitrant ulnar wrist pain. Bone Joint J. 2013. DOI: 10.1302/0301-620x.95b12.31918
  • A novel technique of all-inside arthroscopic triangular fibrocartilage complex repair. Arthroscopy. 2007. DOI: 10.1016/j.arthro.2007.02.010
  • All-arthroscopic repair of peripheral triangular fibrocartilage complex tears using FasT-Fix. Hand Clin. 2011. DOI: 10.1016/j.hcl.2011.05.004
  • Management of peripheral triangular fibrocartilage complex tears in the ulnar positive patient: arthroscopic repair versus ulnar shortening osteotomy. J Hand Surg Am. 2010. DOI: 10.1016/j.jhsa.2010.06.015
  • Arthroscopic diagnosis and treatment of dorsal wrist ganglion. J Hand Surg Br. 2001. DOI: 10.1054/jhsb.2001.0620
  • Arthroscopic resection of dorsal wrist ganglia and treatment of recurrences. J Hand Surg Br. 2000. DOI: 10.1054/jhsb.1999.0290
  • Recurrence rates of dorsal wrist ganglion cysts after arthroscopic versus open surgical excision: a retrospective comparison. HAND. 2021. DOI: 10.1177/15589447211003184
  • Treatment of ganglion cysts. ISRN Orthop. 2013. DOI: 10.1155/2013/940615

Wrist arthroscopy / TFCC rehabilitation literature (URLs)

  • Clinical and functional outcomes of rehabilitation strategies following arthroscopic repair of chronic isolated peripheral TFCC tears: a scoping review. J Orthop. 2025. PMC. https://pmc.ncbi.nlm.nih.gov/articles/PMC12274733/
  • Current rehabilitation recommendations following primary triangular fibrocartilage complex foveal repair surgery: a survey of Australian hand therapists. J Hand Ther. 2024. https://www.jhandtherapy.org/article/S0894-1130(23)00117-5/fulltext
  • TFCC injuries: how we treat? J Clin Orthop Trauma / PMC. 2020. https://pmc.ncbi.nlm.nih.gov/articles/PMC7384326/
  • Review and update on the management of triangular fibrocartilage complex injuries in professional athletes. World J Orthop. 2024. https://www.wjgnet.com/2218-5836/full/v15/i2/110.htm
  • Arthroscopic-assisted repair of the triangular fibrocartilage complex. J Hand Surg Glob Online. 2024. https://www.jhsgo.org/article/S2589-5141(24)00066-5/fulltext

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Section 1 -- Definitions.

a. Adapted Material means material subject to Copyright and Similar Rights that is derived from or based upon the Licensed Material and in which the Licensed Material is translated, altered, arranged, transformed, or otherwise modified in a manner requiring permission under the Copyright and Similar Rights held by the Licensor. For purposes of this Public License, where the Licensed Material is a musical work, performance, or sound recording, Adapted Material is always produced where the Licensed Material is synched in timed relation with a moving image.

b. Adapter's License means the license You apply to Your Copyright and Similar Rights in Your contributions to Adapted Material in accordance with the terms and conditions of this Public License.

c. Copyright and Similar Rights means copyright and/or similar rights closely related to copyright including, without limitation, performance, broadcast, sound recording, and Sui Generis Database Rights, without regard to how the rights are labeled or categorized. For purposes of this Public License, the rights specified in Section 2(b)(1)-(2) are not Copyright and Similar Rights.

d. Effective Technological Measures means those measures that, in the absence of proper authority, may not be circumvented under laws fulfilling obligations under Article 11 of the WIPO Copyright Treaty adopted on December 20, 1996, and/or similar international agreements.

e. Exceptions and Limitations means fair use, fair dealing, and/or any other exception or limitation to Copyright and Similar Rights that applies to Your use of the Licensed Material.

f. Licensed Material means the artistic or literary work, database, or other material to which the Licensor applied this Public License.

g. Licensed Rights means the rights granted to You subject to the terms and conditions of this Public License, which are limited to all Copyright and Similar Rights that apply to Your use of the Licensed Material and that the Licensor has authority to license.

h. Licensor means the individual(s) or entity(ies) granting rights under this Public License.

i. NonCommercial means not primarily intended for or directed towards commercial advantage or monetary compensation. For purposes of this Public License, the exchange of the Licensed Material for other material subject to Copyright and Similar Rights by digital file-sharing or similar means is NonCommercial provided there is no payment of monetary compensation in connection with the exchange.

j. Share means to provide material to the public by any means or process that requires permission under the Licensed Rights, such as reproduction, public display, public performance, distribution, dissemination, communication, or importation, and to make material available to the public including in ways that members of the public may access the material from a place and at a time individually chosen by them.

k. Sui Generis Database Rights means rights other than copyright resulting from Directive 96/9/EC of the European Parliament and of the Council of 11 March 1996 on the legal protection of databases, as amended and/or succeeded, as well as other essentially equivalent rights anywhere in the world.

l. You means the individual or entity exercising the Licensed Rights under this Public License. Your has a corresponding meaning.

Section 2 -- Scope.

a. License grant.

1. Subject to the terms and conditions of this Public License, the Licensor hereby grants You a worldwide, royalty-free, non-sublicensable, non-exclusive, irrevocable license to exercise the Licensed Rights in the Licensed Material to:

a. reproduce and Share the Licensed Material, in whole or in part, for NonCommercial purposes only; and

b. produce, reproduce, and Share Adapted Material for NonCommercial purposes only.

2. Exceptions and Limitations. For the avoidance of doubt, where Exceptions and Limitations apply to Your use, this Public License does not apply, and You do not need to comply with its terms and conditions.

3. Term. The term of this Public License is specified in Section 6(a).

4. Media and formats; technical modifications allowed. The Licensor authorizes You to exercise the Licensed Rights in all media and formats whether now known or hereafter created, and to make technical modifications necessary to do so. The Licensor waives and/or agrees not to assert any right or authority to forbid You from making technical modifications necessary to exercise the Licensed Rights, including technical modifications necessary to circumvent Effective Technological Measures. For purposes of this Public License, simply making modifications authorized by this Section 2(a) (4) never produces Adapted Material.

5. Downstream recipients.

a. Offer from the Licensor -- Licensed Material. Every recipient of the Licensed Material automatically receives an offer from the Licensor to exercise the Licensed Rights under the terms and conditions of this Public License.

b. No downstream restrictions. You may not offer or impose any additional or different terms or conditions on, or apply any Effective Technological Measures to, the Licensed Material if doing so restricts exercise of the Licensed Rights by any recipient of the Licensed Material.

6. No endorsement. Nothing in this Public License constitutes or may be construed as permission to assert or imply that You are, or that Your use of the Licensed Material is, connected with, or sponsored, endorsed, or granted official status by, the Licensor or others designated to receive attribution as provided in Section 3(a)(1)(A)(i).

b. Other rights.

1. Moral rights, such as the right of integrity, are not licensed under this Public License, nor are publicity, privacy, and/or other similar personality rights; however, to the extent possible, the Licensor waives and/or agrees not to assert any such rights held by the Licensor to the limited extent necessary to allow You to exercise the Licensed Rights, but not otherwise.

2. Patent and trademark rights are not licensed under this Public License.

3. To the extent possible, the Licensor waives any right to collect royalties from You for the exercise of the Licensed Rights, whether directly or through a collecting society under any voluntary or waivable statutory or compulsory licensing scheme. In all other cases the Licensor expressly reserves any right to collect such royalties, including when the Licensed Material is used other than for NonCommercial purposes.

Section 3 -- License Conditions.

Your exercise of the Licensed Rights is expressly made subject to the following conditions.

a. Attribution.

1. If You Share the Licensed Material (including in modified form), You must:

a. retain the following if it is supplied by the Licensor with the Licensed Material:

i. identification of the creator(s) of the Licensed Material and any others designated to receive attribution, in any reasonable manner requested by the Licensor (including by pseudonym if designated);

ii. a copyright notice;

iii. a notice that refers to this Public License;

iv. a notice that refers to the disclaimer of warranties;

v. a URI or hyperlink to the Licensed Material to the extent reasonably practicable;

b. indicate if You modified the Licensed Material and retain an indication of any previous modifications; and

c. indicate the Licensed Material is licensed under this Public License, and include the text of, or the URI or hyperlink to, this Public License.

2. You may satisfy the conditions in Section 3(a)(1) in any reasonable manner based on the medium, means, and context in which You Share the Licensed Material. For example, it may be reasonable to satisfy the conditions by providing a URI or hyperlink to a resource that includes the required information.

3. If requested by the Licensor, You must remove any of the information required by Section 3(a)(1)(A) to the extent reasonably practicable.

4. If You Share Adapted Material You produce, the Adapter's License You apply must not prevent recipients of the Adapted Material from complying with this Public License.

Section 4 -- Sui Generis Database Rights.

Where the Licensed Rights include Sui Generis Database Rights that apply to Your use of the Licensed Material:

a. for the avoidance of doubt, Section 2(a)(1) grants You the right to extract, reuse, reproduce, and Share all or a substantial portion of the contents of the database for NonCommercial purposes only;

b. if You include all or a substantial portion of the database contents in a database in which You have Sui Generis Database Rights, then the database in which You have Sui Generis Database Rights (but not its individual contents) is Adapted Material; and

c. You must comply with the conditions in Section 3(a) if You Share all or a substantial portion of the contents of the database.

For the avoidance of doubt, this Section 4 supplements and does not replace Your obligations under this Public License where the Licensed Rights include other Copyright and Similar Rights.

Section 5 -- Disclaimer of Warranties and Limitation of Liability.

a. UNLESS OTHERWISE SEPARATELY UNDERTAKEN BY THE LICENSOR, TO THE EXTENT POSSIBLE, THE LICENSOR OFFERS THE LICENSED MATERIAL AS-IS AND AS-AVAILABLE, AND MAKES NO REPRESENTATIONS OR WARRANTIES OF ANY KIND CONCERNING THE LICENSED MATERIAL, WHETHER EXPRESS, IMPLIED, STATUTORY, OR OTHER. THIS INCLUDES, WITHOUT LIMITATION, WARRANTIES OF TITLE, MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, NON-INFRINGEMENT, ABSENCE OF LATENT OR OTHER DEFECTS, ACCURACY, OR THE PRESENCE OR ABSENCE OF ERRORS, WHETHER OR NOT KNOWN OR DISCOVERABLE. WHERE DISCLAIMERS OF WARRANTIES ARE NOT ALLOWED IN FULL OR IN PART, THIS DISCLAIMER MAY NOT APPLY TO YOU.

b. TO THE EXTENT POSSIBLE, IN NO EVENT WILL THE LICENSOR BE LIABLE TO YOU ON ANY LEGAL THEORY (INCLUDING, WITHOUT LIMITATION, NEGLIGENCE) OR OTHERWISE FOR ANY DIRECT, SPECIAL, INDIRECT, INCIDENTAL, CONSEQUENTIAL, PUNITIVE, EXEMPLARY, OR OTHER LOSSES, COSTS, EXPENSES, OR DAMAGES ARISING OUT OF THIS PUBLIC LICENSE OR USE OF THE LICENSED MATERIAL, EVEN IF THE LICENSOR HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH LOSSES, COSTS, EXPENSES, OR DAMAGES. WHERE A LIMITATION OF LIABILITY IS NOT ALLOWED IN FULL OR IN PART, THIS LIMITATION MAY NOT APPLY TO YOU.

c. The disclaimer of warranties and limitation of liability provided above shall be interpreted in a manner that, to the extent possible, most closely approximates an absolute disclaimer and waiver of all liability.

Section 6 -- Term and Termination.

a. This Public License applies for the term of the Copyright and Similar Rights licensed here. However, if You fail to comply with this Public License, then Your rights under this Public License terminate automatically.

b. Where Your right to use the Licensed Material has terminated under Section 6(a), it reinstates:

1. automatically as of the date the violation is cured, provided it is cured within 30 days of Your discovery of the violation; or

2. upon express reinstatement by the Licensor.

For the avoidance of doubt, this Section 6(b) does not affect any right the Licensor may have to seek remedies for Your violations of this Public License.

c. For the avoidance of doubt, the Licensor may also offer the Licensed Material under separate terms or conditions or stop distributing the Licensed Material at any time; however, doing so will not terminate this Public License.

d. Sections 1, 5, 6, 7, and 8 survive termination of this Public License.

Section 7 -- Other Terms and Conditions.

a. The Licensor shall not be bound by any additional or different terms or conditions communicated by You unless expressly agreed.

b. Any arrangements, understandings, or agreements regarding the Licensed Material not stated herein are separate from and independent of the terms and conditions of this Public License.

Section 8 -- Interpretation.

a. For the avoidance of doubt, this Public License does not, and shall not be interpreted to, reduce, limit, restrict, or impose conditions on any use of the Licensed Material that could lawfully be made without permission under this Public License.

b. To the extent possible, if any provision of this Public License is deemed unenforceable, it shall be automatically reformed to the minimum extent necessary to make it enforceable. If the provision cannot be reformed, it shall be severed from this Public License without affecting the enforceability of the remaining terms and conditions.

c. No term or condition of this Public License will be waived and no failure to comply consented to unless expressly agreed to by the Licensor.

d. Nothing in this Public License constitutes or may be interpreted as a limitation upon, or waiver of, any privileges and immunities that apply to the Licensor or You, including from the legal processes of any jurisdiction or authority.

Creative Commons is not a party to its public licenses. Notwithstanding, Creative Commons may elect to apply one of its public licenses to material it publishes and in those instances will be considered the “Licensor.” The text of the Creative Commons public licenses is dedicated to the public domain under the CC0 Public Domain Dedication. Except for the limited purpose of indicating that material is shared under a Creative Commons public license or as otherwise permitted by the Creative Commons policies published at creativecommons.org/policies, Creative Commons does not authorize the use of the trademark "Creative Commons" or any other trademark or logo of Creative Commons without its prior written consent including, without limitation, in connection with any unauthorized modifications to any of its public licenses or any other arrangements, understandings, or agreements concerning use of licensed material. For the avoidance of doubt, this paragraph does not form part of the public licenses.

Creative Commons may be contacted at creativecommons.org.